Drug List 1-5 Flashcards
Ibuprofen trade name
Motrin Advil
Naproxen trade name
Aleve Naprosyn
Indomethacin trade name
Indocin
Celecoxib trade name
Celebrex
Meloxicam trade name
Mobic
Diclofenac trade name
Voltaren
Trolamine salicylate trade name
Aspercreme
NSAID medications
Ibuprofen Naproxen Indomethacin Aspirin Celecoxib Meloxicam Diclofenac Trolamine salicylate
NSAID indications
analgesia antipyretic anti-inflammatory
Aspirin indications
analgesia antipyretic anti-inflammatory antithrombotic
NSAID MOA
reversibly inhibits COX-1 and COX-2 enzymes to decrease prostaglandin formation
how is Aspirin’s MOA different from other NSAIDS?
it irreversibly binds to COX enzymes, other NSAIDs reversibly bind
general NSAID’s AE
GI N/V dyspepsia ulcers GI bleeding increased BP nephrotoxicity CV risk
Rare Aspirin AE
skin rash photosensitivity bronchospams Raye Syndrome in Children
NSAIDs common routes
PO topical IM IV
Aspirin common routes
PO rectal
Opioid drugs
Codeine Hydrocodone Hydrocodone w/acetaminophen Morphine Oxycodone Oxycodone w/acetminophen Fentanyl Hydromorphone Meperidine Tramadol
Hydrocodone w/acetaminophen trade name
Vicodin
Morphine trade name
MS Contin
Oxycoden trade name
Oxycotin
Oxycodone w/acetaminophen trade name
Percocet
Fentanyl trade name
Duragesic
Hydromorphone trade name
Dilaudid
Meperidine trade name
Dermerol
what opioid can be perscribed as an antitussive?
codeine
Opioid Indication
analgesia
Opioid common routes
PO rectal IV topical subcutaneous intrathecal intranasal transmucosa epidural
Opioid MOA
bind to opioid receptors in the CNS to inhibit ascending pain pathways
Opioid AE CNS effects
sedation nausea respiratory depression cough suppression miosis truncal rigidity
Opioid Peripheral AE
constipation urinary retention bronchospasms reduced GI motility pruitis
Acetaminophen trade name
Tylenol
Acetaminophen Indications
analgesia antipyretic combo with NSAID to reduce NSAID dose
Acetaminophen Common routes
PO IV rectal
Acetaminophen MOA
inhibits prostaglandin synthesis in CNS
Acetaminophen AE
hepatotoxicity (esp w/alcohol)
Corticosteroids Drug List
Cortisone, Prednisone, Methylprednisolone, Prednisolone, Triamcinolone, Betamethasone
Corticosteroids Indication
RA, anti-inflammatory
Corticosteroids Common routes
PO, IV, intra-articular, topical
Corticosteroids MOA
decrease inflammation and suppress immune system
Short term corticosteroid AE
inc blood glucose, mood changes, fluid retention
Long term Corticosteroids AE
osteoporosis/ increased fracture risk, thin skin, muscle wasting, poor wound healing, adrenal suppression, Cushing’s disease, increased risk of infection from immunosuppression
brand name Gabapentin
Neurontin
Gabapentin indication
neuropathic pain
Gabapentin drug class
GABA analog, anticonvulsant
Gabapentin common route
PO
Gabapentin MOA
bind to alpha 2-delta subunit of a calcium channel to block its effects
Gabapentin AE
dizziness, drowsiness
Azathioprine drug class
immunosuppresant
Azathioprine indication
SLE
Azathioprine common routes
PO, injectible
Azathioprine MOA
decreases the immune response so the body doesn’t attack itself
Azathioprine AE
N/V
Hyaluronate trade name
Synvisc, Gel-One, Orthovisc
Hyaluronate indication
OA
Hyaluronate common route
injection
Hyaluronate MOA
viscoelastic solution to provide joint lubrication
Hyaluronate AE
injection site pain, swelling, rash
Lidocaine drug class
anesthetics
propofol drug class
anesthetics
anesthetic drugs
lidocaine, propofol
anasthetic drugs indications
patient controlled analgesia
general anasthetic common routes
IV, inhalation
regional anasthetic common routes
intrathecal, epidural, inflitration anesthesia, peripheral nerve block, IV, regional block
local anasthetic common routes
injection, topical
which antibiotic classes inhibit cell walls?
Penecillins, Cephalosporins Glycopeptides
which antibiotic classes inhibit protein synthesis?
Aminoglycides Tetracyclines Macrolides
which antibiotic classes inhibit DNA/RNA?
Fluoroquinolones, Nitroimidazole Antifolates
what pre/suffixes are associated with antibiotics that inhibit cell wall?
-cillin, ceph-, -vancin
what pre/suffixes are associated with antibiotics that inhibit protein synthesis?
-mycin -micin -cyclin
what pre/suffixes are associated with antibiotics that inhibit DNA/RNA?
-floxacin -idazole Sulfa-
Penecillins, Cephalosporins Glycopeptides
which antibiotic classes inhibit cell walls?
Aminoglycides Tetracyclines Macrolides
which antibiotic classes inhibit protein synthesis?
Fluoroguinolones, Nitroimidazole Antifolates
which antibiotic classes inhibit DNA/RNA?
-allin ceph- -vancin
what pre/suffixes are associated with antibiotics that inhibit cell wall?
-mycin -micin -cyclin
what pre/suffixes are associated with antibiotics that inhibit protein synthesis?
-floxacin -idazole Sulfa-
what pre/suffixes are associated with antibiotics that inhibit DNA/RNA?
which antibiotic drug classes are gram +/-
Penecillins,
Tetracyclines
Macrolides
Antifolates
C-diff infection is treated using what antibiotic?
metronidazole
vancomycin
what antibiotic is used to treat respiratory infection?
macrolides
what antibiotic is used to treat community based pnemonia?
fluoroquinolones
what antibiotics are used to treat MRSA and Staph infections?
Linozolid
AE of antifolates
steven-johnson syndrome
allergies
AE of fluoroquinolones
Tendon rupure
hypoglycemia
AE of Penecillins
Allergies, GI distress
AE of cephalosporins
GI hypersentivity
AE of aminoglycides
ototoxicity
nephrotoxicity
photosensitivity
Macrolides AE
N/V/D
drug/drug interactions
AE Glycopeptides
hypotension (fall risk)
nephrotoxicity
redman syndrome
which antiobiotics can be administered as eye drops (opthalmic)?
Aminoglycocides
Fluoroquinolones
Macrolides
Nitroimidazole AE
GI
metallic taste
nausea
headache
which antiobiotics can rarely cause peripheral neuropathy?
Nitroimadzaole
How would aminoglycocides increase fall risk?
affects vestibular function (ototoxicity
potential AE of Linozolid
serotonin syndrome
thrombocytopenia
PT specific pertaining to TB trx
CN VIII damage - increases fall risk
tetracycline AE
GI distress, photosensitivity
what broad AE should you be concerned about concerning antibiotics?
GI distress (specifically diarrhea)
basic pathophysiology of cancer
uncontrolled cell growth
causes of cancer
1). extrinsic: carcinogens 2). Intrinsic: genetic mutations/DNA sequences, viral agents, chronic irritation, genetic predisposition, oncogenes
General stages of cell lifecycle
G0: cell at rest G1: Pre-DNA S: DNA synthesis G2: pre-mitosis Mitosis
cell-cycle-specific (CCS) agents do what?
target specific phase of cell cycle
what are CCS agents more effective on?
rapidly dividing tumors
dose frequency of CCS agents
continuous infusion or frequent doses
cell-cycle nonspecific (CCN) agents do what?
target the cell during it’s entire life cycle (including G0)
What areas of the body are primarily adversely affected by chemotherapy?
bone marrow, GI, buccal mucosa, reproductive organs, hair follicles
what are CCN agents more effective on?
slow large growing tumors
dose frequency/timing of CCN agents
intermittently dose to reduce toxicities
what is Nadir?
10-28 days when WBC is at it’s lowest, no trx given here
what stage of the cell life cycle is chemotherapy not effective?
G0: cell at rest
primary treatment (cure) for cancer
surgery, radiation, chemotherapy, biotherapy
when is adjuvant therapy used?
after primary trx
when is neoadjuvant therapy used?
before primary trx
goals/stages of treatment
cure, control palliative
what is palliative care?
decrease tumor burden, improve QOL, relieve pain
Types of cancer trx
radiation, surgery, pharmacotherapy,
what is used to treat almost every solid tumor?
radiation
Radiation trx AE
1). significant damage to all tissues 2). can result in fibrosis of lungs (location dependent) 3). fatigue
PT concerns for radiation
fatigue, location of tissue damage
Cancer trx used to maximize tumor eradication
surgery
PT considerations for surgery trx
wound complications, lymphedema, general post-op concerns
what are the 3 types of pharmacotherapy?
1). chemotherapy 2). targeted therapy 3). immunotherapy
chemotherapy
drugs that inhibit growth and replication of cancer cells
targeted therapy
blocks genes/proteins, specific genetic mutations
immunotherapy
hormones and drugs that use the immune system to trx cancer
majority of immunotherapy drugs utilize what?
antibodies that end in -mab, interferon, interleukins (non-specific immunotherapy)
what cancer AE should we be most concerned with?
1). thrombocytopena 2). neutropenia 3). peripheral neuropathy 4). pain 5). infection 6). mouth/throat
special precautions for oral chemotherapy
wear gloves when touching laundry or bodily fluids (specific to the oral med)
suffix associated with most antiviral drugs
-vir
AE influenza A & B
N/V/D, fever (the flu)
which forms of Hepatitis do not have a vaccine?
C, D, E
T/F: hepatitis D and E are common in the US
False
how is hepatitis B treated?
1). Interferon (weekly injection) 2). Nucleoside/Nucleotide analog (better, PO)
AE of Interferon
flu-like symptoms
common AE for DAAs
fatigue, weakness, headache, nausea
PT concern with DAAs + corticosteroids
Bradycardia
what does HIV target?
immune system -> CD4 T cells
result of HIV progression?
decreased CD4 count leading to AIDS
how is HIV treated?
HAART (Highly Active Antiretroviral Treatment)
what is HAART?
combo therapy to increase efficacy and decrease resistance
patient specific factor in successful management of HIV
ADHERENCE
MOA of antivirals
target different points in lifecycle
Rehab concerns specific to HIV
1). opportunistic infections 2). Neuromuscular problems (myopathy, peripheral neuropathy) 3). pt trx include pain management
types of fungal infections
1). superficial 2). systemic
patients at risk for fungal infections
immunosuppression, antibacterial, diabetics, burn victims
*antifungal drugs basic MOA
alter cell membrane permeability
2 antifungal classes
1). polyenes, 2). azoles
which antifungal drug class is broad spectrum
azoles
PD implications of azoles
common CYP interactions
which antifungals commonly have DDI?
Azoles
Polyene drugs
Nystatin, Amphotericin B
Nystatin AE
N/V/D, cramps (PO), rash, urticaria (topical)
Azole drugs
Fluconazole, ketoconazole
Azole drugs AE
N/V, photophobia, cardiac arrhythmia, menstrual irregularities,
primary concern with antifungals
liver damage, elevated serum transaminase kidney damage
What are the types of vaccines?
1). inactivated 2). subunit/conjugated 3). attenuated 4). toxoid
what is in an inactivated vaccine?
killed pathogen
what is in a conjugated vaccine?
piece of the pathogen
what is in a live attenuated vaccine?
weakened pathogen
what is in a toxoid vaccine?
pathogen toxin instead of actual pathogen
which vaccine is good for life?
life attenuated
which vaccine should be avoided in immunocompromised populations?
life attenuated
areas of virus lifecycle that a virus can impact
1). going into and out of cell (binding/budding) 2). movement in cell (uncoating) 3). replication (translation/transcription/assembly)
what is used to treat Hepatitis C?
DAA
What is a therapeutic concern when treating a patient with hepatitis C?
bradycardia
for an acute infection of of Hepatitis A what is recommended?
rest, hyrdate, antipyretic drugs, AVOID acetaminophen, typically takes 2-6 months to recover
name all the categories of antiviral drugs
antiherpes, anti-influenza, antihepatitis, miscellanis
